Testing time would benefit fiftysomething men

It's time for men and women to check themselves, says Dr Christian Jessen

Lord Mandelson's prostate is currently enjoying the limelight.

He recently underwent an operation to help the symptoms of an enlarged prostate gland. He is absolutely the right age for this.

Your fifties are the decade during which, for men and women, things do tend to start to go wrong.

Joints get achy, circulatory problems manifest themselves and prostates begin to play up.

I speak from experience: my father started getting prostate trouble at this age.

It started with him taking longer to pee, and the stream was weaker. He also started having to get up several times during the night to pee.

For men, who rarely have to see a doctor much before this time, that first prostate-related consultation can be a rude awakening.

The dreaded "brown finger test", as my father calls it, reminds men why they tended to avoid doctors in the first place.

Measuring the level of prostate-specific antigen (PSA), a protein secreted by the gland that helps to liquefy semen, can indicate prostate trouble, but it is a controversial test.

PSA levels can rise if the prostate is disturbed by benign enlargement, digital examination, prostatitis, anal sex or even bike-riding, as well as by prostate cancer.

This lack of specificity is one reason why the test is not part of a national screening programme.

The problem is that any rise in PSA really ought to be followed up but such tests are often invasive and so come with risks.

In the US, Republicans attacking "Obamacare" quoted a study from The Lancet which found that the death rate from prostate cancer is much lower in America than it is here.

They concluded that it was rationing in the NHS that was at fault. But their reasoning was wrong.

The US does far more general check-ups than we do.

American men have their PSA checked regularly while here it is unusual to meet someone who has an annual test.

So American cancers are going to be picked up earlier and therefore stand a better chance at cure.

My view is that men over 50, especially those who have a family history of prostate cancer, ought to know what their PSA is and should monitor it on a regular basis.

In the US 70 per cent of men know what their PSA is, compared with six per cent in the UK, and they have witnessed a four times greater fall in the number of prostate cancer deaths over the past 10 years.

This suggests that PSA testing does reduce prostate cancer deaths.

Studies that should clarify these complex issues are being done as I write, but for now, getting used to the concept of taking an interest in their bodies once a year could save men's lives.